Heat 1 teaspoon olive oil in a wide pot over medium-high heat. Once hot, add the sausage and cook, breaking it up with a spoon as it cooks for 12–15 minutes or until completely cooked through. Transfer to a paper towel-lined plate.

Heat the remaining 2 teaspoons oil in the same pot and turn the heat to medium. Add the onion and cook, stirring occasionally, for 15–20 minutes. Adjust the heat as needed to prevent the onion from burning. Once the onion begins to deepen in color, add a pinch of sugar and continue cooking until completely soft and golden brown, 5–10 minutes more. Season with salt and pepper.

Melt the butter into the onion. Add the confit garlic, piment d’Espelette, and crushed red pepper. Cook for 1 minute, mashing the garlic into the onion as it cooks. Return the cooked sausage to the pot.

Pour in the water and bring to a boil. Add the parmesan rind and then reduce the heat to medium-low. Simmer, uncovered, for 30 minutes or until the sauce reduces and begins to thicken. Adjust heat as needed if the sauce reduces too quickly. Season with salt and pepper to taste. Discard the parmesan rind.

Pour in the heavy cream and turn the heat to medium. Let the cream bubble and thicken for 5 minutes. Add the lemon juice and season once more with salt and pepper. Reduce heat to low.

Bring a large pot of water to a boil and add a generous amount of salt. About 10 minutes before the sauce finishes cooking, add the orecchiette to the water. 2 minutes before the orecchiette finishes cooking, add the broccoli rabe to the pot of boiling water. After 2 minutes, drain the pasta and broccoli rabe.

Add the cooked pasta, broccoli rabe, and grated parmesan cheese to the sauce; toss to coat. Taste and season once more.

Divide the cooked pasta between shallow bowls. Garnish with minced parsley, more parmesan, and a drizzle of extra virgin olive oil if you like. Enjoy!